| Organization Name: | CENTENNIAL GROUP LLC |
| NPI Number: | 1609235050 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK CANLAS ANTOLIN (MANAGER) |
| Mailing Address: | 4535 W Sahara Ave Suite 108 Las Vegas |
| State: | NV US |
| Postal Code: | 891023625 |
| Phone Number: | 7025275553 |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2016 |
| NPI Last Update Date: | 02/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 8419HPC-0 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |